At these meetings we have an opportunity for resolving doubts by discussion, or it may be of only discovering that in confessing an ignorance which is not singular there is no great sacrifice of self-esteem. I am ready to accept either alternative as the result of our consideration of recoveries from mental disease.

The object of this paper is not so much to relate anything that is new as to show that mental symptoms are not always easy of classification when associated with organic changes in nerve tracts outside the cerebral cavity.

I have now dealt at some length with atypical and unusual conformations of brain-surface relevantly to mental standing, by description both of the general and of the local deviations from more usual arrangement; and have described aberrant brain-forms—abnormal defects or aberrations of cerebral gyres and furrows—which may serve as a stigma of degeneracy in the stock from which the individual springs; or may arise from disturbances in the very foundations of being, due to pathological and developmental anomaly during intra-uterine or during early extra-uterine life. In the course of the preceding chapters it has been necessary to discuss so many matters, and with so much detail, concerning the brain-surface morphology, that it will now be useful to resume, on lines both broad and brief, some of the principal features of interest and importance.

Dr. Mott gave a demonstration by means of lantern slides and microscopical specimens to illustrate “some points concerning the degeneration of the neuron.”

He pointed out that the “neuron” must be considered as a very complex cell with processes, of which, as Golgi had maintained, one is the neuraxon or axis cylinder process, the others dendrons. The dendrons receive the impulse which, passing through the cell, is conveyed to the neuraxon. Every neuron is an independent protoplasmic unit, anatomically distinct, in contiguity with other neurons, but not in continuity.

For some years past the leading authorities have been generally agreed that the neuroglia is a tissue composed exclusively of special cells and their processes. Ramon y Cajal, for example, describes it as consisting of small cells provided with very fine, wavy, and only slightly ramified processes, which, after a variable course, terminate freely or attach themselves to the surface of the capillaries. From observations made with the aid of a new method, Professor Weigert, of Frankfurt, has arrived at a theory regarding the constitution of the neuroglia which is diametrically opposed to this now generally accepted view. He published a preliminary note on the subject in 1890, but it was only a year ago that he gave a full account of his researches, together with a description of an important improvement in his method. This improved method, in which methyl violet is the staining agent employed, is one that is exceedingly complicated and troublesome to carry out. It gives preparations in which the neuroglia-fibres and the nuclei of the neuroglia-cells are stained violet, while the protoplasm of the cells remains unstained and invisible. The reaction succeeds only in the human subject, and, as a rule, only with tissues that are moderately fresh. The results that he has obtained with this method have led Weigert to advocate the view that the neuroglia-fibres, which have hitherto been regarded as processes of the Deiters' cells, are chemically distinct, and morphologically separate, from the cell-protoplasm; in other words that the fibres which are stained violet in his preparations are not processes of the cells, but are completely differentiated from them. It is clear that we cannot rightly understand the nature of the pathological changes that occur in the neuroglia until this question of the structure of the normal tissue is settled in our minds. Weigert's theory is certain to give rise to a large amount of discussion in the near future. I wish now to offer merely a small contribution to that discussion. I have for some weeks been working with Weigert's method in the course of a study of the normal histology and pathological anatomy of the neuroglia. Already I feel convinced in my own mind that Weigert has been led into an error by certain fallacious appearances produced by his method, and that the older view of the structure of the neuroglia is the correct one.

Under the term “Housing the Insane” I wish to bring before you for discussion the various plans that have been adopted of providing for the insane in asylums, colonies, homes, &c., the extent to which they are practicable, the medical supervision they necessitate, together with the size and form of institution which might result from their combination.

The present is the day when we are searching for any deviation from the normal type, that we may put it down as a sign of degeneracy, a word that is having a more and more extended meaning, and is already serving an evil purpose as signifying more than is actually warranted. Formerly a degenerate was an individual so different physically and mentally from the average, that he could be set off into a class by himself. We knew him when we saw him, because he was distinct from the average. Now it needs only some slight imperfection of development in an organ, or tissue, or some slight irregularity of action in the brain as shown in speech, or action, to brand an individual as presenting indications of degeneration.

Being engaged, in the course of anthropometrical observations, upon an examination of the hard palate amongst the inmates of an asylum, I have endeavoured to make out a suitable method for the purpose. The proper basis of all such study, I believe, must be cast-taking. Seeing that the procedure to which I am about to refer is only rendered possible by the preparation of a cast of the hard palate, any value which may attach thereto is secondary in importance to the cast-taking. Dr. Eugene S. Talbot, the distinguished American writer upon deformities of the skull and jaws, has devised instruments for measuring the palate, either in the living subject or in casts. For the following method no special instruments are needed; and this may be accounted an advantage. Dr. John R. Lord, clinical assistant at the Joint Counties Asylum, Carmarthen, has been associated with me in working out the details of this method, and I am indebted to him for valuable assistance in cast-taking.

The fact that the Medico-Psychological Association has now upon its register upwards of 2,400 nurses, including both sexes, who hold the certificate of the Association “for proficiency in nursing,” renders it unnecessary to offer any apology to this meeting for bringing before it the question of considering the position in which we now stand with regard to our nurses and to the public.

The following case may serve the purpose of illustrating a few remarks on the subject of Post-Operative Insanity, which, perhaps, has not received as much attention in this country as might have been expected.

Dr. A. W. Campbell, by way of illustrating the uses of formol, gave a microscopic demonstration of a series of specimens, normal and pathological, taken from various parts of the nervous system, and therewith proved that in formolhardened portions of nervous tissue it was possible to satisfactorily stain all the constituent elements of those tissues and likewise to clearly demonstrate almost all the pathological changes in them which are to be revealed by other previously discovered methods.

That grave difficulties will always exist in the treatment of cases of melancholia in lunatic hospitals is evident to anyone who has lived in such places and considered the matter. The mere congregation of so many distressed beings of different types under one roof is a disadvantage, as patients have to hear and bear numberless griefs in addition to their own, and many painful delusions are suggested to them which might never have entered their own minds.

In popular estimation there is no surer relief from itching than by scratching. The lower classes have no better remedy for anger than cursing. The more educated indulge in reproaches and complaints often referring to other causes than the immediate source of irritation. Experience, however, has taught us that, in only too many instances, the practices thus indulged in are positively deleterious; and that abnormal feeling is further aggravated by giving way to these impulses of reflex action. Still, there is a momentary relief, and a feeling of comfort which in a great number of cases is all that can be expected by the physician.